The Case of the Tumbling Tumbleweed

Abstract

Thus far, the literature in psychotherapy research on the relationship between specific factors and treatment outcome has focused on discrete, well-defined disorders. In contrast, this case study reviews a man who presents with a complex diagnostic picture. As a result, the student clinician drew from the literature examining the role of common factors, specifically of a supportive nature, in psychotherapy outcome. The client exhibited features from a variety of both Axis I and Axis II ailments, including alcohol dependence, sexual masochism, paraphilias, and borderline personality disorder. The challenges of case conceptualizing and treating an individual exhibiting multiple comorbid conditions are presented.